The Therapeutic Effects Of Yunnan Baiyao On Moderate Or Severe Traumatic Brain Injury In Patients

Background： Traumatic brain injury（TBI）is a common issue in the field ofneurosurgery,which has a very high mortality and morbidity. Over the years,anumber of scholars from home and abroad has been committed to the clinicaltreatment of TBI and related basic research. Currently,the main treatment is stillsurgery combined with drugs.However,the treatment of TBI is still not idealbecause of the stagnant development of surgery and the uncertain or limited rolein the efficacy of many important drugs.In recent years, the process of treatmentof TBI, Traditional Chinese medicine(TCM) began to be concerned.EspeciallyAngong Niuhuang Pill and its derivative Xingnaojing Injection(XNJI) achieved acertain effect in the clinical treatment of TBI,which were proved to improve therate of one week sober and reduce mortality.So TCM may be one of thebreakthrough point in treating TBI.Objective: Yunnan Baiyao(YNBY)is used in the proeess of treating TBI,andthen systematical evaluation is made about its efficacy by internationalindicators(GCS,GOS,KPS,S100B protein,etc).And research part of mechanism ofYunnan Baiyao’s effect.It is expected to look for a new neuroprotective drugs forclinical treatment of TBI.Methods: Development of strict diagnostic criteria,inclusion criteria andexclusion criteria, there are80cases who met the requirement are selected fromSeptember2010to October2011.All cases were randomly divided into4groups:normal control group(groupA), XNJI treatment control group(group B)，low-dose (0.25g/times) YNBY treatment group(groupC), high-dose (0.5g/times)YNBY treatment group(group D)，20patients in each group. Patients in eachgroup should be at least8days of drug treatment.Of these,group A was applied tothe only routine treatment before and after surgery; group B was injected with XNJI on the basis of group A on the sacrificing blood sample once after admissionand twice a day for7days after surgery which was given to consumptionaccording to the instructions;group C was taken0.25g YNBY by tube or warmwater4times/day on the basis of group A;group D was the same as group C in theadministration time and method,but the dose became0.5g/times.In the firstpart,we observed the clinical efficacy of YNBY by GCS,GOS and KPS.In thesecond part,we dynamically observed that S100B protein and SOD activity.Results:(1) GCS in group B,C,D were significantly better than that in group Astarting at3rd days after treatment(P<0.05or P<0.01). Furthermore, comparedwith admission,the average of GCS score in group B,C,D was significantlyhigher than pre-treatment levels on the3rd,5th,7th day (P<0.05). However,compared with admission, the average of GCS score in group A was nosignificant difference on the third day(P>0.05) and significant differences on thefifth,seventh day(P<0.05).(2)GOS in group B,C,D were better than that in groupA for1month and3months follow-up (P<0.05). Though KPS in four groups atone month were no difference,that in the other three groups at three months weresignificantly higher than that in group A(P<0.05).(3)S100B protein in groupB,C,D were obviously lower than that in group A at3rd,5th,7th days aftertreatment(P<0.05or P<0.01).(4) The activity of SOD in four groups was nosignificant difference on admission and the first day after treatment(P>0.05).However, the activity in group B,C,D was obviously higher than that in group Aat3rd,5th,7th days after treatment(P<0.05or P<0.01).Conclusion: YNBY can significantly improve GCS,GOS and KPS for themoderate or severe TBI in patients.It can not only reduce S100B protein lever,butalso enhances SOD activity. The possible neuroprotective mechanism is partly dueto reducing oxygen free radicals,inhibiting lipid peroxidation and preventing thedamage of free radical-mediated neurotoxicity.